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Individual

KENNETH A. URBAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
1624 E MASON ST, GREEN BAY, WI 54302-2739
(920) 465-0400
(920) 465-1430
Mailing address
1624 E MASON ST, GREEN BAY, WI 54302-2739
(920) 465-0400
(920) 465-1430

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1483
WI
111NS0005X
Sports Physician Chiropractor
1483
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
38757000
WI
Enumeration date
10/04/2006
Last updated
11/28/2011
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